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A new system for the grading and assessment of Lichen Planopilaris – including a form of scarring hair loss – has now started clinical trials.

Frontal Fibrosing Alopecia is a clinical variant of Lichen Planopilaris, which causes a thick band of hair loss around the hairline which leaves behind a pale, smooth band of skin; although it can present in men, it largely only affects women over 40 years of age.

Researchers at Massachusetts General Hospital, Boston, USA, have designed a new diagnostic test for Lichen Planopilaris and Frontal Fibrosing Alopecia, which is currently being trialled on 40 volunteers.

Measure severity over time

Hair Loss Research Study

The observational study is assessing its Boston Grade of Activity in Lichen Planopilaris (Boston GOAL) tool over the course of six months. It hopes to prove that it is a valid, objective and accurate method which dermatologists and medical specialists can use when diagnosing and monitoring patients with the rare inflammation-based condition.

During the trial they will use the Boston GOAL tool to rate changes in participants’ symptoms, including pain and itchiness, using a Numeric Rating Scale (NRS) and scores from the Dermatology Life Quality Index (DLQI).

The grades allocated using the trial tool will be correlated with patients’ skin biopsies, which the study author notes will be “evaluating disease activity on a microscopic level”, as well as with digital global photography and trichoscopy images.

According to data submitted via the registration information at clinicaltrials.gov, all of the participants – a mix of male and female – are between 18 and 80 years of age, with a clinical and histologic diagnosis of lichen planopilaris but otherwise in general good health.

It is estimated that this trial, which was first registered in 2017, should be completed by September 2019, with the study ending a few months later in December. As such, it is likely that findings will be made available at the very end of 2019 or in early 2020.

Dealing with Frontal Fibrosing Alopecia

An Example of Frontal Fibrosing Alopecia which Causes a Receding Hairline in Women
An Example of Frontal Fibrosing Alopecia which Causes a Thick, Receding Hairline, and is Mostly Seen in Post-Menopausal Women

The inflammation symptomatic of this autoimmune disease can destroy hair follicles, leaving them incapable of producing hair regrowth.

Currently, there is no authorised hair loss treatment for Frontal Fibrosing Alopecia. Due to the nature of the condition, hair restoration surgery is an unlikely possibility, though it depends on the extent of the condition and other factors, not least the skill of the individual hair transplant surgeon.

Treating Frontal Fibrosing Alopecia involves trying to manage the inflammation, rather than concentrating on encouraging hair growth. This is generally done via steroid use and/or anti-malarial drugs, as advised and prescribed by the patient’s GP or dermatologist.

In addition to trying to address the underlying cause of this balding, patients may need emotional support in coping with the psychological effects of hair loss.

This is where peer support groups, hair loss charities and even counsellors or therapists can be useful, both in terms of providing advice and coping mechanisms, and to foster a feeling of community and inclusion, so that those with Frontal Fibrosing Alopecia are not isolated and have others with shared experiences to lean on.


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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There are well-established links between stress and hair loss and, as many in the UK will attest, there are currently few scenarios as stressful as Brexit.

Due to the uncertainty, divisions and general tension this political omnishambles has been causing across the UK, Brits may not just be leaving the European Union behind – they may well be losing their hair, too.

Here we explain how ‘Brexit baldness’ may be a real issue, and what to do if this type of hair loss happens to you.

Stress and ‘Brexit grief’

brexit stress hair loss belgravia centre

In addition to not knowing what kind of deal will be negotiated, nor how it will impact the country’s economy and people’s everyday lives, there are many people also feeling anxious about becoming something of an isolated island nation again.

This long-standing issue has been going on since the result of the extremely close 2016 EU Referendum vote results were announced, and numerous instances of associated stress have been reported since then.

According to a Bloomberg article published in December 2018, “Since the original vote in 2016, there has been a 13.7 percent increase in prescriptions for antidepressants relative to other drugs. Political chaos has consequences for public health.

Indeed, the results of a new study suggest that people subjected to long periods of intense uncertainty show levels of immune-system activity similar to that when triggered by viral or bacterial infections.”

‘Brexit grief’ is the term coined for feelings such as loss, helplessness, anger and a sadness at the change in identity – particularly for those born after 1973 who have grown up ‘European’- that are being seen as a result of Britain leaving the EU.

“It wouldn’t necessarily fit the clinical diagnostic criteria of grief or complicated grief,” Dr Chloe Paidoussis-Mitchell, an experienced therapist and grief counsellor, tells HuffPost UK. “But it is a loss. It’s the loss of what we know, the country we felt we knew, and the loss of the community we thought we belonged to – which was the European community. I do think that it affects us in a really big way.”

Whether you voted to remain or leave, the messy situation surrounding the whole Brexit debacle – whether it be a hard Brexit, a no-deal Brexit, extended talks or, indeed, no Brexit at all – these are worrying times for the UK.

In addition to the emotional toll, this turmoil may result in behaviours that can cause physical stress to the body and consequently induce hairloss. These include regular lack of sleep, not eating properly or having poor nutritional habits, doing less exercise than normal, smoking and/or drinking more.

Thinning hair caused by Brexit worries

When we endure intense periods of stress – whether physical, emotional, or both – it can spark a hair loss condition which, whilst it tends to be more commonly found in women, can also affect men.

This is called Telogen Effluvium and it presents as diffusely thinning hair across the whole scalp.

Its onset may appear sudden and shocking, due to as much as 50 per cent of a person’s scalp hair being affected at once, but it is actually triggered around three months prior to the shedding becoming noticeable.

Telogen Effluvium causes temporary hair loss and tends to last for approximately six months, with normal hair regrowth resuming naturally in many cases, though treatment is also available to help speed recovery along.

When the shedding is more intense and lasts for longer than six months, it is considered Chronic Telogen Effluvium, sometimes also referred to as Diffuse Thinning. Again, this may clear up on its own but Chronic Telogen Effluvium treatment is also a possibility.

Whilst these may seem fairly insignificant due to their temporary nature, for those with existing cases of genetic hair loss, or with a family history of Male Pattern Baldness and/or Female Pattern Hair Loss, the consequences could be more long-lasting.

These permanent, hereditary conditions can be exacerbated by Telogen Effluvium, if they are already present, and their premature onset can be sparked if there is an underlying genetic predisposition.

Hair fall from both conditions can occur simultaneously, which can make the areas of the scalp affected by genetic hairloss – namely the top of the scalp from crown to hairline – appear much thinner, even once the temporary shedding has subsided.

If you notice extra hair fall, a drop in hair density or see other signs of hair loss, it may be beneficial to consult a specialist so they can diagnose exactly what is causing the problem.

Whilst Belgravia experts can’t solve the Brexit problem, if warranted, a tailored hair loss treatment course can be recommended to tackle the shedding, whilst holistic stress-management techniques, from exercise and relaxation practices such as yoga, to meditation and counselling, can be used in tandem, to help control the cause of any stress-related hair loss.


The Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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One of the many JAK inhibitor drugs that has recently been explored as a potential treatment for the autoimmune disorder Alopecia Areata is baricitinib.

This oral rheumatoid arthritis medication has already been explored by a number of researchers, including a team from the Department of Dermatology at Columbia University, USA, and the pharmaceutical company, Incyte, as a possible hair loss solution for mild to severe Alopecia Areata.

Now Lilly Korea has announced it has received the green light for a randomized, double-blind, placebo-controlled, adaptive phase 2/3 clinical trial from the Ministry of Food and Drug Safety – the Korean equivalent of the UK’s MHRA and the FDA in America – to explore the drug for this same purpose.

Xeljanz versus Olumiant?

Lilly Korea manufactures baricitinib under the brand name of Olumiant for the Korean and American markets; this is referred to in the trial data as LY3009104. It is taken by rheumatoid arthritis patients once per day, which Korea Biomedical Review advises gives it a competitive advantage over Pfizer’s rheumatoid arthritis medication, Xeljanz which is taken twice daily.

Diagram Belgravia Centre Different Types of Alopecia Areata autoimmune hair loss
Areas affected by hair loss shown in blue

Whilst this ‘competition’ relates to the increasing number of rheumatoid arthritis patients reportedly choosing Olumiant over Xeljanz, it would appear the two medications may also be competing on the hairloss front too.

Xeljanz is the brand name for Pfizer-produced tofacitinib citrate, another JAK inihibitor which has also been explored – seemingly quite successfully – for the treatment of severe autoimmune alopecia.

In 2014, Yale University discovered its hair loss treatment potential when they used it experimentally to treat a plaque psoriasis patient who also happened to be bald due to Alopecia Universalis. There is currently no significantly effective treatment for this condition.

This is the most extreme form of Alopecia Areata and causes total baldness from head to toe, whereas Alopecia Areata causes patchy hair loss often called ‘spot baldness’ to the scalp only, and Alopecia Totalis leaves the scalp hairless and can also cause facial hair loss, including losing eyebrows and eyelashes.

The Yale patient experienced full hair regrowth after being treated with various doses of oral tofacitinib for eight months. The 25 year old had not previously grown hair for seven years, after this autoimmune disease was triggered.

Pfizer is still hoping to win the race to bring the first ever JAK inhibitor-based Alopecia Areata treatment for all forms of the often distressing disorder, with its two candidates PF-06700841 and PF-06651600.

However, pharmaceutical company, Aclaris Therapeutics was awarded patents relating to the use of tofacitinib as a treatment for Alopecia Areata, Totalis and Universalis, covering the USA and Japan in late 2017.

Alopecia Areata treatment options

It is estimated that the first fully authorised Alopecia Areata treatments capable of treating even the most extensive baldness caused by the condition, will be based on JAK inhibitors, and could be ready for approval and licensing by medical regulatory boards as early as 2021/2022.

Until then, Alopecia Areata treatment relating to the mild-to-moderate, scalp-only form has been shown to often produce promising results in adults. For those with more expansive forms or for children with any alopecia phenotype, hospital-based treatments such as steroids or topical immunotherapy may be beneficial. These do, however, generally tend to have a smaller success rate.

In cases where hair regrowth does not occur spontaneously – often a possibility within 12 months of it starting for scalp-only instances – a hair loss specialist or dedicated hair loss charity can often provide helpful advice, treatment recommendations where appropriate, and support.


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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Pharmaceutical titan Pfizer is the latest company to announce its hair loss news at the 2019 Annual Meeting of the American Academy of Dermatology in Washington DC, USA.

Promising results, showing what Dermatology Advisor describes as a ‘rapid therapeutic effect’, were provided from its randomised Phase 2a clinical trial into two separate treatment options for the autoimmune disorder Alopecia Areata, PF-06700841 and PF-06651600.

Both of these JAK inhibitors are designed to treat both patchy hair loss from moderate Alopecia Areata, through to the more extensive forms, Alopecia Totalis and Alopecia Universalis.

The new information was an update from earlier data released regarding these novel hair loss solutions at the EADV conference in September 2018.

race speed

With the FDA already monitoring this project and granting it ‘breakthrough status’, these new developments could signal that Pfizer may be winning the race to be the first to introduce FDA-approved and MHRA-licensed Alopecia Areata treatments based on JAK inhibitors. This is despite strong competition from the likes of Concert Pharmaceuticals which believes it may pip Pfizer to this particular post.

Full head of hair after 24 weeks

Pfizer’s 24-week trial involved 142 patients, both male and female, aged between 18 and 75 years old. All participants had a professional diagnosis of moderate to severe autoimmune alopecia – either Alopecia Areata, Alopecia Totalis or Alopecia Universalis.

The volunteers were randomly assigned one of three separate treatments for the first four weeks – 48 were allocated 200 mg per day of PF-06651600, a tyrosine kinase 2 inhibitor (TYK2) and JAK1 inhibitor; 47 were given 60 mg per day of the janus kinase 3 (JAK3) inhibitor PF-06700841; 47 were administered a placebo.

This phase of the trial started with 4 weeks of treatment, followed by a 20-week maintenance period. During this maintenance stretch, the PF-06651600 candidates used a 50 mg daily dose, whilst the PF-06700841 group took 30 mg per day.

Both active medications reportedly started to show hair regrowth results at the 4 week (PF-06700841) and 6 week (PF-06651600) marks, based on changes to the participants’ Severity of Alopecia Tool (SALT) scores from baseline.

Researchers noted that, within the PF-06700841 group, those who had been experiencing Alopecia Areata hair loss the longest (for 3.5 years or more, consecutively) had a slower response time of 8 weeks, compared to 4 weeks for those whose current episode had been going on for less than 3.5 years.

However, at the end of the 24-week trial, it was noted that all responders using either PF-06700841 or PF-06651600, had regrown a full head of hair.

Final results coming soon

The study completion date for this Phase 2a stage of the trial is currently registered as May 2019, so we could have the final findings within the next 10-12 weeks.

Once medications have successfully passed Phase III of the clinical trial process, and obtained the relevant authorisations from medical regulatory boards, such as the MHRA and FDA in the UK and USA respectively, they can then be released for prescription in those countries.

Although the scalp-only form tends to see hair regrowth occur naturally within 12 months of its onset in many cases, Alopecia Areata treatment is also available and with an often significant success rate, for this mild-to-moderate phenotype. A hair loss specialist can recommend appropriate solutions following a consultation, either in person or online, in these instances.

Further information and updates from this clinical trial and the numerous others currently underway in the hopes of developing the first JAK inhibitor-based Alopecia Areata treatment will be published here on the Belgravia hair loss blog. Details for this Pfizer trial can also be monitored via its official clinical trial documentation.


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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As part of its 2019 Annual Meeting, the American Academy of Dermatology (ADD) heard the latest clinical trial interim results update on CTP-543, a potential treatment for even the most extreme forms of Alopecia Areata.

The ADD hosted a presentation from its developers, Concert Pharmaceuticals, as part of the Late-Breaking Research Program on 2nd March 2019, in Washington DC, USA.

CTP-543 is a novel drug created from a deuterium chemistry-modified version of ruxolitinib – the JAK inhibitor and blood disorder medication, often known by its brand name, Jakafi.

CTP-543 Phase 2 trial achieves key aim

CTP-543 alopecia areata treatment phase 2a clinical trial results announcement March 2019

In January of this year it was announced that new cohorts were being introduced to the on-going CTP-543 Phase 2 trial in March 2019. These involved investigating higher doses of the drug, with findings due for release in December 2019.

The ADD presentation explored the interim results of the 104-patient, randomised CTP-543 Phase 2a trials regarding the 4mg and 8mg doses, compared to placebo.

These showed that treatment with an 8mg dose of
CTP-543 administered twice per day resulted in “statistically significant greater hair regrowth” for those patients, when compared to the control group receiving a placebo treatment. Changes in hair loss and hair regrowth were measured by scoring each participant’s amount of shedding before and at the end of the trial, using the Severity of Alopecia Tool (SALT).

It was stated that 47% of participants treated with 8 mg of CTP-543 twice-daily reduced their SALT score by more than 50% overall, compared to only 8.6% of those using the placebo twice-per-day over the same 24 week period.

A roughly even spread of Alopecia Areata, Alopecia Totalis and Alopecia Universalis was noted among the responders in the 47% group.

The fact that, for these patients, hair regrowth did not show signs of plateauing by the end of the trial period, was also recorded.

Non-serious side effects noted

One of the concerns surrounding JAK inhibitors – the janus kinase inhibiting suite of drugs which includes ruxolitinib, on which CTP-543 is based, as previously mentioned – is safety and the potential side effects.

The presentation, given by Concert’s Chief Development Officer,
James V. Cassella, Ph.D., advised that no serious adverse events were reported during the trial.

However, other side effects from this interim analysis were disclosed. The most commonly found complaints were headache, upper respiratory tract infection, cough, acne and nausea.

In a Concert Pharmaceuticals press release regarding this presentation, Dr. Brett King, a prominent hairloss researcher and Associate Professor of Dermatology at Yale School of Medicine, advised “The data for CTP-543 shows that JAK inhibitors have the potential to be an effective treatment option for patients with this challenging disease.”

Alopecia Areata treatments in development

At present, whilst there are many studies going on into potential hair loss treatments for the various forms of autoimmune alopecia, there are three which are considered of particular significance.

These are Concert’s CTP-543, Aclaris Therapeutics’ ATI-502, and Pfizer’s PF-06651600.

The reason these have established themselves as front-runners in the race to develop the first treatments to be authorised by both the MHRA and FDA, is due to their early recognition by the FDA.

Whilst the first two have been received Fast Track awards by the American food and drug regulatory board, the latter Pfizer trial has been given Breakthrough status. This means these three projects will receive special, expedited assistance from the FDA, in order to ensure trial findings relating to these medications are reviewed as quickly as possible.

This suggests that the research involved in the development of each novel therapy – all involving or based on JAK inhibitors – has been deemed of sufficient integrity and interest to be worth the regulator’s attention.

Although Alopecia Areata which affects the scalp only will generally clear up naturally within 12 months, there are various treatment options available, which can often prove successful. A consultation with a hair loss specialist can help to determine the relevant options and the individual’s suitability for them.

The more severe phenotypes – Alopecia Totalis and Alopecia Universalis – currently have fewer effective treatments and are generally less likely to see hair regrowth, however. With the possibility of effective future treatments looking to be closer than ever – with an estimated release date of 2022 for some, assuming everything goes to plan – this situation may change within the next few years.


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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Belgravia Centre Hair Loss Treatment Before and After Results - New Success Story

A new entry has just been added to Belgravia’s Female Pattern Hair Loss Treatment Success Stories gallery.

This client says “losing hair could be a challenge but you guys made everything easier.”

Find out what more she had to say and see her regrowth results close up, or find out more about treating hereditary hair loss in women by clicking the buttons below…

(Results may vary and are not guaranteed)

VIEW SUCCESS STORY

Female Hair Loss Treatment Information

Alopecia Areata Treatment Information


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

The ‘sunshine vitamin’ vitamin D has frequently been linked to hair growth and having a potentially beneficial result on certain hair loss issues.

It is a subject regularly explored in clinical trials, particularly with regards to the autoimmune disorder Alopecia Areata.

Researchers at Aswan University Hospital in Egypt have reportedly now completed an interventional trial comparing the efficacy of calcipotriol ointment to narrow band UVB phototherapy in treating, and elevating the vitamin D3 (cholecalciferol) levels, in adults with patchy hair loss from scalp-only Alopecia Areata.

Diagram Belgravia Centre Different Types of Alopecia Areata autoimmune hair loss
Areas affected by hair loss shown in blue

People with the more extensive phenotypes – Alopecia Totalis and Alopecia Totalis – which cause the entire head or the whole body from head to toe, to also become hairless, were excluded from the study.

Vitamin D3 levels

According to trial registration information published on the clinicaltrials.gov database, there were three interventional arms used and one control group (IV) which was given a placebo.

One arm involved participants in group II being treated with a narrow band UVB device, whilst group I was treated with topical calcipotriol. Group III was treated with both narrow band UVB and calcipotriol ointment.

Calcipotriol is a synthetic derivative of a type of vitamin D known as calcitriol. It is currently widely used in cream form to treat the skin condition plaque psoriasis, which is also an autoimmune disease.

UVB phototherapy delivered to the scalp via a narrow band device uses these rays to help stimulate the follicles into accelerating hair growth, in a similar way to how Low Level Laser Therapy (LLLT) devices, such as the HairMax LaserBands work. These FDA-cleared devices are currently not recommended for Alopecia Areata, however.

Results, which were measured at the 3 month mark, were assessed using the Severity of Alopecia Tool (SALT) and the serum vitamin D levels (ng/ml) with both sets of readings compared from before and after completing the course.

Although the clinical trial was completed on 31st December 2018, and the registration documentation was updated to confirm this on 21st February 2019, the findings have not yet been released.

Dealing with scalp-only Alopecia Areata

Interestingly, when Alopecia Areata only affects the scalp, generally causing sudden hair loss which results in one or many rounded bald patches of varying sizes, in many cases hair regrowth tends to occur naturally within 12 months.

It is also the phenotype with the highest success rate from treatment; although there are not currently any MHRA-licensed nor FDA-approved medications for this specific purpose, there are a number of Alopecia Areata treatment options for adults which have proved to be effective in treating the scalp-only form.

At Belgravia we offer consultations to adults concerned about losing their hair – for whatever reason – and, once a hair loss specialist has made a diagnosis, personalised treatment recommendations can then be made.

Further assistance, in the form of peer support and recommendations for therapists who may help those affected to better cope with Alopecia Areata, can be found from hair loss charities, such as Alopecia UK. The work of these dedicated organisations should not be undervalued as their assistance can form a crucial part in any holistic approach to tacking hairloss.


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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Picture this… after developing the classic signs of Male Pattern Hair Loss you make the decision to go bald gracefully.

umbrella scalp protection shade rain weather

You shave your head, let nature take its course and over the years your thinning hair gradually causes your scalp to become fully exposed to the elements.

Or, you develop patchy hair loss from the autoimmune disorder Alopecia Areata – or total baldness of the scalp from its more severe iterations, Alopecia Totalis or Alopecia Universalis. Again, leaving your naked scalp displayed either wholly or in part.

In each instance, and in the case of other hair loss conditions where the scalp becomes exposed, there is a whole area of newly-revealed skin that needs taking care of and protecting.

But how many people are actually aware of why this is so important?

Actinic keratosis and skin cancer

One of the best things people who are bald can do to protect their scalp is to use a good quality sunscreen or sunblock on their head, ensuring it is regularly reapplied as necessary, based on the product’s instructions.

Those who are not necessarily bald but have thinning hair on top – something which is often symptomatic of Female Pattern Hair Loss – may find applying sun creams to their scalp tricky. There are, however, many dedicated sun protection sprays for the scalp and hair available now.

Of course, hats or other head coverings can also be used, but it is important to ensure you block as many of the sun’s UV rays as possible given the less hair there is, the less protection the head has from sunburn.

When there is no hair on top of the head, ultraviolet (UV) rays from daylight, or artificial UV light sources, are better able to penetrate the skin in this area, as well as the top of the ears, which would otherwise generally be better shaded by hair. Continues below…

Actinic keratoses on scalp condition can be sign of pre-cancer skin cancer
An example of actinic keratosis (solar keratosis) on the scalp

This is why researchers, from Danish company LEO Pharma, developing treatments for Actinic Keratosis – a potentially pre-cancerous condition which causes a crusty, scaly scalp from repeated UV exposure – used men with extensive hair loss as their trial subjects.

According to official advice on actinic keratosis from the UK’s National Health Service (NHS), the rough patches of skin that this scalp condition – also known as solar keratosis – can cause, “aren’t usually a serious problem and can go away on their own, but it’s important to get them checked as there’s a chance they might turn into skin cancer at some point”.

It tends to affect areas that are most frequently exposed to sunlight, including the face, hands, forearms and lower legs as well as the ears and scalp.

Skin cancer prevention is the primary reason for ensuring proper scalp care featuring a suitable sunblock or high SPF sun cream is practised daily, all year round. Don’t forget, UV rays can penetrate even on cloudy days, not just sunny ones.

Other scalp conditions

Belgravia Centre B4 Medicated Shampoo treatment shampoo

Many scalp conditions, including psoriasis, can be autoimmune and hereditary in nature, and will therefore present whether you have hair or not; obviously if you are bald or have extensive hairloss, they may simply become more noticeable.

Whilst others, such as seborrhoeic dermatitis, which – when it affects the head – causes a red, itchy and scaly-looking scalp that flakes easily, are not genetic, but have other triggering factors such as an overgrowth of, or an over-active immune response to yeast found on the skin called Malassezia furfur. This is most likely to affect those prone to allergies, hayfever, asthma and eczema, and is generally worse in dry and cold weather.

These cannot be prevented, but practising good scalp hygiene, such as washing the scalp daily, is recommended. Patients are generally advised to use a tailored shampoo – often medicated shampoo with formulations including zinc pyrithione, selenium sulphide, coal tar or ketoconazole – as these can be beneficial and ease symptoms. It is important to follow the usage directions as some may only be used every other day, for example, or on a short-term basis.

It you are concerned about problems with your scalp, a hair specialist or dermatologist should be able to provide you with a diagnosis and appropriate treatment recommendations, following a consultation.


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

Related Stories


When people – women, in particular – lose their hair to extensive Alopecia Areata, one of the decisions they face is whether or not to wear a wig.

Rugby player, Heather Fisher has been vocal in the past about her choice not to wear one, opting to boldy display her bald head. Her hair loss, caused by Alopecia Universalis, means the 34 year old’s body has rejected her hair follicles from head to toe, leaving her entirely hairless.

heather fisher rugby tries wig

Taking nothing away from the courage it takes to make such a statement in an increasingly image-obsessed society, Fisher thought she might fancy a change occasionally – for the warmth if nothing else! She took to social media to share her trying out a custom wig for the first time, and the reasons behind her slight change of heart.

Not trying to hide

In a frank Instagram post Fisher explained that she wasn’t trying out a wig in order to hide, but just to see what it was like, making it clear that whether someone decides to wear a wig or not does not matter – both options are ok.

“…always been almost afraid of a wig because it isn’t real.. and for those of u who know me know I’m true to me.. so on this bases it didn’t feel right to wear one or consider one .. but sometimes it would just be nice to know I can dress up and still be me,” she wrote in the accompanying caption.

After having the wig cut and styled by a hairdresser, the rugby union and sevens star said, “Gonna take some getting used to but love it !”

Opportunity to blend in – or stand out

Fisher is known for her positivity and refreshing honesty in discussing the autoimmune disorder which caused her to start losing her hair aged 25. She has admitted how, even despite her mental toughness, coping with such extensive hair loss has been a real struggle at times.

Although new options for all forms are in development, Alopecia Areata treatment currently tends to only have significant success rates when treating the scalp-only version of the condition.

As such, one of the draws a wig offered the amiable flanker was giving her the ability to blend in, should she choose to.

“I never knew that wearing a wig would bring emotions of anger and frustration but it does .. trust me .. so this stage of having a custom made piece just gives me the opportunity to sometimes blend in!! Although , don’t the best people always stand out…”


Circ - Belgravia Centre Hair Loss Clinics LondonThe Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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The full results for Yale University’s clinical trial investigating whether topical tofacitinib could prove a safe and effective method of treating mild-to-severe Alopecia Areata were published on 30th January 2019.

Alopecia Areata is an autoimmune disorder which causes the body to attack its own hair follicles, leading to anything from rounded patchy bald spots on the scalp to full baldness from head-to-toe. Tofacitinib is a drug from a suite known as Janus Kinase inhibitors – or JAK inhibitors – which are being trialled to address these currently largely untreatable conditions, as they appear to prevent the immune system response against the follicles.

The small-scale trial was first registered with the clinicaltrials.gov website in June 2016, with a summary of its findings being made available in October 2018.

One of the key takeaways from this research is the apparently minimal side effect profile the JAK inhibitor showed during this study. This is something which had been a potential cause for concern given the adverse effects previously associated with the oral form of this medication, currently only authorised for prescription use as a treatment for rheumatoid arthritis.

No serious adverse effects reported

The Yale University research was led by the Ivy League college’s Associate Professor of Dermatology, Dr. Brett King, who is a well-known and respected specialist in the field of autoimmune alopecia.

Of the US-based Phase 2 trial’s 10 participants, 8 were Caucasian and 2 were Asian; 4 were women and 6 were men, all of whom were 18 years of age or older, with a mean age of 36.9 years.

The group’s mean SALT score (the measurement using the Severity of Alopecia Tool) was 77.7 – meaning an average amount of hair loss per volunteer of just over three quarters of the scalp.

The recruits each had extensive Alopecia Areata or one of its more extreme phenotypes which each cause total baldness of the scalp, as well as affecting other hair-bearing areas of the head and/or body – Alopecia Totalis and Alopecia Universalis.

All ten test subjects were treated for up to six months with topical tofacitinib ointment, and assessed every four weeks.

The efficacy of the medication, for which the dose information was not provided, was evaluated on the changes in hair growth at the end of treatment compared to the individuals’ baseline measurements from just before the study commenced.

Whilst little data is provided, even in this final outcome report, it appears that a mean average of 10 per cent decrease in participants’ SALT score was recorded (where the lower the SALT score corresponded to the more hair growth that occurred) over the six months period. It was also stated that 30 per cent – or three – of the volunteers who responded well to this treatment were then analysed.

Of all the ten patients who took part, it was notable that none reported any serious adverse events over a 12 month period. This includes the six months during which they were using topical tofacitinib and the following six months afterwards when they were not.

The only side effects users complained of were considered mild, with 2 out of 10 experiencing headaches, 4 having an upper respiratory infection, 1 having a sinus infection, 1 developing folliculitis and 4 noting skin irritation of their scalp.

Importance of developing severe Alopecia Areata treatments

Despite research finding that Alopecia Areata is less distressing than Male and Female Pattern Hair Loss is to those affected, it is well established that the sudden hair fall and visible nature of the condition can have traumatic effects. A number of mental health disorders, including depression and anxiety, have been shown to be triggered following the onset of these autoimmune diseases.

Although Alopecia Areata treatment can be beneficial for the patchy, scalp only form – which in most cases will clear up naturally within 12 months – the options are far more limited and often less successful when it comes to the more severe phenotypes.

Because of this ‘unmet need’, the American medical regulatory board, the FDA, has granted fast track status to a number of potential therapies for all types of Alopecia Areata, which are all in the latter stages of development.

In a news article on the Yale Medicine website, Dr. King explains the reasons behind his pursuit of JAK inhibitor treatment for Alopecia Areata in all its forms – for both adults and children.

“Some may argue it’s just hair,” he says. “But hair frames the person you see in the mirror. It’s a sign of youth and vitality—of life. Patients have told me that without hair, eyebrows and eyelashes, they feel like ghosts.”

“For us, this is about giving people back normalcy and giving them the opportunity to achieve everything they have the potential to become.”

JAK inhibitors are not currently available for prescription as a hair loss treatment outside of clinical trials, in the UK, USA nor any other country that we are aware of. However, in March 2017 Dr. King estimated JAK inhibitors may be ready for release – assuming the relevant medical authorisations from organisations such as the MHRA and FDA are forthcoming and granted in a timely manner – by 2021.

With a number of trials in the Phase 3 stage already, we would assume that – again, if everything goes to plan – these should be available from 2021-2022, and will publish any new information regarding this timeline here on the Belgravia hair loss blog.


The Belgravia Centre

The Belgravia Centre is an organisation specialising in hair growth and hair loss prevention with two clinics and in-house pharmacies in Central London, UK. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the world. View our Hair Loss Success Stories, which includes the world’s largest gallery of hair growth comparison photos and demonstrates the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time to arrange a free consultation.

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